NPI: 1568433100 · BETHLEHEM, PA 18018 · General Practice Dentistry · NPI assigned 01/31/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 448 | $10K |
| 2019 | 249 | $6K |
| 2020 | 654 | $14K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D0120 | Periodic oral evaluation - established patient | 419 | 417 | $10K |
| D1110 | Prophylaxis - adult | 197 | 195 | $8K |
| D0272 | Bitewings - two radiographic images | 250 | 250 | $5K |
| D1208 | Topical application of fluoride, excluding varnish | 237 | 237 | $4K |
| D1120 | Prophylaxis - child | 48 | 48 | $1K |
| D0274 | Bitewings - four radiographic images | 30 | 30 | $837.45 |
| D0602 | 58 | 58 | $450.00 | |
| D0330 | Panoramic radiographic image | 12 | 12 | $444.00 |
| D0220 | Intraoral - periapical first radiographic image | 40 | 36 | $320.00 |
| D1330 | 60 | 60 | $290.00 |